OBJECTIVE: To describe the proportion of children adhering to recommended physical activity and dietary guidelines, and examine demographic and household correlates of guideline adherence. DESIGN: Cross-sectional (pre-randomization) data from a behavioral intervention trial designed to prevent unhealthy weight gain in children. PARTICIPANTS: A total of 421 children (aged 5-10 years) at risk for obesity (body mass index percentile, 70-95). MAIN OUTCOMES MEASURED: Physical activity (accelerometry), screen time (parent survey), and fruit and vegetable and sugar-sweetened beverage intake (24-hour dietary recall). ANALYSIS: Proportions meeting guidelines were calculated. Logistic regression examined associations between demographic and household factors and whether children met recommended guidelines for (1) physical activity (>/= 60 min/d), (2) screen time (/= 5 servings/d), and (4) sugar-sweetened beverage avoidance. RESULTS: Few children met more than 1 guideline. Only 2% met all 4 recommended guidelines and 19% met none. Each guideline had unique sociodemographic and domain-specific household predictors (ie, availability of certain foods and beverages, media, and active play and exercise equipment). CONCLUSIONS AND IMPLICATIONS: Families equipped to promote healthy child behavior patterns in 1 activity or dietary domain may not be in others. Results have implications for the development of interventions to affect children's weight-related behaviors and growth trajectories.